# Successful Treatment of Type 3b Endoleak after AFX Using TREO

## TL;DR

A TREO stent-graft successfully treated a type 3b endoleak in a patient who previously had an AFX stent-graft for aneurysm repair.

## Contribution

The study demonstrates the effectiveness of using the TREO stent-graft for relining the AFX in type 3b endoleak cases.

## Key findings

- The TREO stent-graft enabled easy contralateral gate cannulation.
- The TREO provided a long proximal landing zone for secure placement.
- The TREO appears to be a viable option for treating type 3b endoleaks after AFX use.

## Abstract

Late postoperative type 3 endoleaks associated with the AFX (Endologix, Irvine, CA, USA) stent-graft are commonly reported. The AFX’s endoskeletal design raises concerns about wire entrapment between its frame and fabric, as well as a risk of type 1a endoleak. An 84-year-old man with prior EVAR using the AFX presented with a type 3b endoleak 4 years postoperatively. He underwent relining with the TREO stent-graft (Terumo Aortic, Sunrise, FL, USA), which enabled easy contralateral gate cannulation and secured a long proximal landing zone. The TREO appears to be a viable option for relining the AFX in type 3b endoleak cases.